Format

Send to

Choose Destination
Drug Alcohol Depend. 2015 May 1;150:112-9. doi: 10.1016/j.drugalcdep.2015.02.030. Epub 2015 Mar 6.

Long-term outcomes from the National Drug Abuse Treatment Clinical Trials Network Prescription Opioid Addiction Treatment Study.

Author information

1
McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA. Electronic address: rweiss@mclean.harvard.edu.
2
McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
3
McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
4
McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
5
McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Department of Biostatistics, Harvard School of Public Health, 677 Huntington Street, Boston, MA 02115, USA.
6
Department of Psychiatry, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA.

Abstract

BACKGROUND:

Despite the growing prevalence of prescription opioid dependence, longitudinal studies have not examined long-term treatment response. The current study examined outcomes over 42 months in the Prescription Opioid Addiction Treatment Study (POATS).

METHODS:

POATS was a multi-site clinical trial lasting up to 9 months, examining different durations of buprenorphine-naloxone plus standard medical management for prescription opioid dependence, with participants randomized to receive or not receive additional opioid drug counseling. A subset of participants (N=375 of 653) enrolled in a follow-up study. Telephone interviews were administered approximately 18, 30, and 42 months after main-trial enrollment. Comparison of baseline characteristics by follow-up participation suggested few differences.

RESULTS:

At Month 42, much improvement was seen: 31.7% were abstinent from opioids and not on agonist therapy; 29.4% were receiving opioid agonist therapy, but met no symptom criteria for current opioid dependence; 7.5% were using illicit opioids while on agonist therapy; and the remaining 31.4% were using opioids without agonist therapy. Participants reporting a lifetime history of heroin use at baseline were more likely to meet DSM-IV criteria for opioid dependence at Month 42 (OR=4.56, 95% CI=1.29-16.04, p<.05). Engagement in agonist therapy was associated with a greater likelihood of illicit-opioid abstinence. Eight percent (n=27/338) used heroin for the first time during follow-up; 10.1% reported first-time injection heroin use.

CONCLUSIONS:

Long-term outcomes for those dependent on prescription opioids demonstrated clear improvement from baseline. However, a subset exhibited a worsening course, by initiating heroin use and/or injection opioid use.

KEYWORDS:

Addiction; Follow-up; Heroin; Opioids; Prescription opioids; Treatment

PMID:
25818060
PMCID:
PMC4407806
DOI:
10.1016/j.drugalcdep.2015.02.030
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center